Financial Payments to Teaching Hospitals by Companies Marketing Opioids
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Division of General Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA; 2Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; 3Department of Population Health, New York University School of Medicine, New York, USA; 4Center for Opioid Epidemiology and Policy, New York University School of Medicine, New York, USA; 5Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA; 6Department of Pediatrics, Boston Medical Center, Boston, MA, USA; 7Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
J Gen Intern Med DOI: 10.1007/s11606-019-05596-1 © Society of General Internal Medicine 2019
the national opioid overdose crisis, media reports A mid and ongoing litigation have shed light on financial relationships between companies marketing opioid medications and teaching hospitals. Financial relationships between teaching hospitals and pharmaceutical companies may influence the education of trainees and physician prescribing practices, creating institutional conflicts of interest which can undermine public trust.1 While prior research indicates financial payments to physicians related to marketing of opioids are widespread and may contribute to increased prescribing frequency2 and dosing,3 little is known about opioid-related payments to academic teaching hospitals. Thus, we examined the prevalence and characteristics of publicly reported payments from companies marketing opioids to US teaching hospitals.
METHODS
We examined all non-research payments made by companies marketing opioids to teaching hospitals reported in the Centers for Medicare and Medicaid Services (CMS) Open Payments database.4 Data were available for payments occurring between August 1, 2013, and December 31, 2018. We identified companies marketing opioids as those reporting any payments related to opioids in the Open Payments database and those listed in the Food and Drug Administration National Drug Codes database as manufacture ring or distributing opioid products.5 We examined all opioids approved for pain management, excluding methadone and buprenorphine/naloxone which are also approved for the treatment of opioid use Received October 8, 2019 Revised October 29, 2019 Accepted December 4, 2019
disorder. Teaching hospitals were identified by CMS certification number. We calculated descriptive statistics on the number, dollar amount, and nature of payments related to opioid products and payments made by companies marketing opioids that were not linked to any product.
RESULTS
During the study period, 31 companies marketing opioids reported making payments to teaching hospitals, of which 18 companies reported making payments specifically linked to the marketing of opioid products (median value of opioidrelated payments per company $194,977; interquartile range [IQR] $14,993 to $561,250). Overall, there were 444 payments linked to opioid products totaling $7,023,140 (median value of individual payment $1348; IQR $245 to $20,291).
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